Childhood Maltreatment and Substance Use in Middle Adulthood: Understanding the Role of Neighborhood Factors
Principal Investigator: Preeti Chauhan, Ph.D.
Background: Prospective studies on childhood maltreatment generally indicate an increased risk for future substance use. A body of research examining factors that mediate the relationship between maltreatment and substance use is beginning to emerge. However, the majority of these studies have examined individual level risk factors such as early substance use, homelessness, prostitution, academic difficulties, and criminal behavior, largely ignoring the crucial role of contextual factors in the development of substance use. The lack of research in this area is surprising, given that studies indicate a relationship between maltreatment and context as well as between context and substance use. To date, no study has prospectively examined either the exacerbating or protective role of neighborhoods in the development of substance use into middle adulthood among maltreated children. This grant will bring together these two disparate bodies of literature to further explicate the complex relationships between maltreatment and substance use.
The Present Study: Using Dr. Cathy Spatz Widom's prospective research design, the proposed grant will examine the mediating role of a host of contextual factors (e.g., neighborhood disadvantage, physical disorder, social cohesion, social control and availability and participation in neighborhood institutions) on alcohol and drug use in middle adulthood among a sample of maltreated children and matched controls. Furthermore, we will examine potential race- (Black versus White) and gender – specific pathways to these substance use outcomes.
As such, the goals of the study are three-fold:
1) Examine group differences (maltreated children and matched controls) in the prevalence of neighborhood disadvantage, physical disorder, social cohesion and control, neighborhood institutions (e.g., community center, religious organization), and substance use in middle adulthood.
2) Determine whether neighborhood context mediates the relationship between childhood maltreatment and middle adulthood outcomes of substance use.
3) Investigate race- and gender-specific relationships.
The grant has several strengths and uniquely positioned to examine the hypotheses described above. First, it uses substantiated cases of maltreatment, thereby not relying on self reports which are prone to biases and memory errors. Second, the inclusion of matched controls decreases the likelihood of other confounding variables that may influence these associations. Third, it is a prospective study allowing us to tease apart the temporal relationships between maltreatment, neighborhood context, and substance use in a more definitive manner relative to cross-sectional studies. Fourth, it assesses a wide range of neighborhood factors using objective (i.e., census data) and subjective indicators (i.e., survey data) to measure both risk and protective factors.
Given these myriad of strengths and lack of research within this area, the results have significant theoretical and programmatic merit. At a theoretical level, it can identify if and to what extent the ecology plays a role in the development of substance use among a high risk group (i.e., maltreated children). Furthermore, the results have the potential to inform community planning and development. For instance, if results indicate that neighborhood institutions were, in fact, protective against substance use, then the placement of greater resources (e.g., community centers) even within disadvantaged neighborhoods would be deemed beneficial.